Subject: The temporary
rule adoptions implement an augmented process for licensure of military spouses
or domestic partners as required by 2013 House Bill 2037. Four rules are included
(broken down by appropriate division of the administrative rules) for medical and
osteopathic physicians, physician assistants, acupuncturists, and podiatric physicians.
Specifically, each rule defines “military spouse or domestic partner,”
provides the qualifications for this augmented process, provides the documents that
will be accepted in lieu of other documents, lists any information that the Board
will obtain on behalf of the applicant, and specifies the additional documents that
will be required as part of this augmented application process.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-020-0165

Application for Licensure by Military Spouse
or Domestic Partner

(1) “Military spouse or domestic
partner” means a spouse or domestic partner of an active member of the Armed
Forces of the United States who is the subject of a military transfer to Oregon.

(2) To qualify for licensure
under this rule, the military spouse or domestic partner must:

(a) Meet the qualifications
for licensure as stated in OAR 847-020-0120, 847-020-0130, and 847-020-0170;

(b) Be married to, or in a domestic
partnership with, a member of the Armed Forces of the United States who is assigned
to a duty station located in Oregon by official active duty military order;

(c) Be licensed to practice
medicine in another state or territory of the United States;

(d) Be in good standing, with
no restrictions or limitations upon, actions taken against, or investigation or
disciplinary action pending against his or her license in any jurisdiction where
the applicant is or has been licensed; and

(e) Have at least one year of
active practice or teaching of medicine during the three years immediately preceding
the application.

(3) If a military spouse or
domestic partner applies for a license to practice medicine, the Board may accept:

(a) A copy of the medical school
diploma to fulfill the requirement for a Dean’s Letter of Recommendation and
the Verification of Medical Education form; and

(b) Verification of licensure
in good standing from the jurisdiction of current or most recent practice of medicine
to fulfill the requirement of verifications of licensure from all jurisdictions
of prior and current health related licensure.

(4) If a military spouse or
domestic partner applies for a license to practice medicine, the Board will obtain
the following on behalf of the applicant:

(a) The results of a query of
the National Practitioner Data Bank; and

(b) The results of a query of
the Federation of State Medical Boards’ Board Action Data Bank.

(5) In addition to the documents
required in section (3) of this rule and by OAR 847-020-0150 and 847-020-0160, the
military spouse or domestic partner must submit a copy of the:

(a) Marriage certificate or
domestic partnership registration with the name of the applicant and the name of
the active duty member of the Armed Forces of the United States; and

(b) Assignment to a duty station
located in Oregon by official active duty military order for the spouse or domestic
partner named in the marriage certificate or domestic partnership registration.

Stat. Auth.: ORS 677.265 & HB 2037
(2013)

Stats. Implemented: ORS 677.010,
677.100, 677.265 & HB 2037 (2013)

Hist.: OMB 21-2013(Temp),
f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14

847-050-0022

Application for Licensure by Military Spouse
or Domestic Partner

(1) “Military spouse or domestic
partner” means a spouse or domestic partner of an active member of the Armed
Forces of the United States who is the subject of a military transfer to Oregon.

(2) To qualify for licensure
under this rule, the military spouse or domestic partner must:

(a) Meet the qualifications
for licensure as stated in OAR 847-050-0020;

(b) Be married to, or in a domestic
partnership with, a member of the Armed Forces of the United States who is assigned
to a duty station located in Oregon by official active duty military order;

(c) Be licensed to practice
as a physician assistant in another state or territory of the United States;

(d) Be in good standing, with
no restrictions or limitations upon, actions taken against, or investigation or
disciplinary action pending against his or her license in any jurisdiction where
the applicant is or has been licensed; and

(e) Have at least one year of
active practice as a physician assistant or teaching at a physician assistant education
program during the three years immediately preceding the application.

(3) If a military spouse or
domestic partner applies for a license to practice as a physician assistant, the
Board may accept:

(a) A copy of the physician
assistant education program diploma to fulfill the requirement for the Verification
of Medical Education form; and

(b) Verification of licensure
in good standing from the jurisdiction of current or most recent practice as a physician
assistant to fulfill the requirement of verifications of licensure from all jurisdictions
of prior and current health related licensure.

(4) If a military spouse or
domestic partner applies for a license to practice as a physician assistant, the
Board will obtain the following on behalf of the applicant:

(a) The results of a query of
the National Practitioner Data Bank; and

(b) The results of a query of
the Federation of State Medical Boards’ Board Action Data Bank.

(5) In addition to the documents
required in section (3) of this rule and by OAR 847-050-0015 and 847-050-0020, the
military spouse or domestic partner must submit a copy of the:

(a) Marriage certificate or
domestic partnership registration with the name of the applicant and the name of
the active duty member of the Armed Forces of the United States; and

(b) Assignment to a duty station
located in Oregon by official active duty military order for the spouse or domestic
partner named in the marriage certificate or domestic partnership registration.

Stat. Auth.: ORS 677.265 & HB 2037
(2013)

Stats. Implemented: ORS 677.265,
677.512 & HB 2037 (2013)

Hist.: OMB 21-2013(Temp),
f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14

847-070-0024

Application for Licensure by Military Spouse
or Domestic Partner

(1) “Military spouse or domestic
partner” means a spouse or domestic partner of an active member of the Armed
Forces of the United States who is the subject of a military transfer to Oregon.

(2) To qualify for licensure
under this rule, the military spouse or domestic partner must:

(a) Meet the qualifications
for licensure as stated in OAR 847-070-0016;

(b) Be married to, or in a domestic
partnership with, a member of the Armed Forces of the United States who is assigned
to a duty station located in Oregon by official active duty military order;

(c) Be licensed to practice
acupuncture in another state or territory of the United States;

(d) Be in good standing, with
no restrictions or limitations upon, actions taken against, or investigation or
disciplinary action pending against his or her license in any jurisdiction where
the applicant is or has been licensed; and

(e) Have at least one year of
active practice or teaching of acupuncture during the three years immediately preceding
the application.

(3) If a military spouse or
domestic partner applies for a license to practice acupuncture, the Board may accept:

(a) A copy of the acupuncture
school diploma to fulfill the requirement for a letter from the Dean of the applicant’s
acupuncture school; and

(b) Verification of licensure
in good standing from the jurisdiction of current or most recent practice of acupuncture
to fulfill the requirement of verifications of licensure from all jurisdictions
of prior and current health related licensure.

(4) In addition to the documents
required in section (3) of this rule and in OAR 847-070-0022, the military spouse
or domestic partner must submit a copy of the:

(a) Marriage certificate or
domestic partnership registration with the name of the applicant and the name of
the active duty member of the Armed Forces of the United States; and

(b) Assignment to a duty station
located in Oregon by official active duty military order for the spouse or domestic
partner named in the marriage certificate or domestic partnership registration.

Stat. Auth.: ORS 677.265 & HB 2037
(2013)

Stats. Implemented: ORS 677.275,
677.759 & HB 2037 (2013)

Hist.: OMB 21-2013(Temp),
f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14

847-080-0016

Application for Licensure by Military Spouse
or Domestic Partner

(1) “Military spouse or domestic
partner” means a spouse or domestic partner of an active member of the Armed
Forces of the United States who is the subject of a military transfer to Oregon.

(2) To qualify for licensure
under this rule, the military spouse or domestic partner must:

(a) Meet the requirements for
licensure as stated in OAR 847-080-0010;

(b) Be married to, or in a domestic
partnership with, a member of the Armed Forces of the United States who is assigned
to a duty station located in Oregon by official active duty military order;

(c) Be licensed to practice
podiatric medicine in another state or territory of the United States;

(d) Be in good standing, with
no restrictions or limitations upon, actions taken against, or investigation or
disciplinary action pending against his or her license in any jurisdiction where
the applicant is or has been licensed; and

(e) Have at least one year of
active practice or teaching of podiatric medicine during the three years immediately
preceding the application.

(3) If a military spouse or
domestic partner applies for a license to practice podiatric medicine, the Board
may accept:

(a) A copy of the podiatric
medical school diploma to fulfill the requirement for a Dean’s Letter of Recommendation
and the Verification of Medical Education form; and

(b) Verification of licensure
in good standing from the jurisdiction of current or most recent practice of podiatric
medicine to fulfill the requirement of verifications of licensure from all jurisdictions
of prior and current health related licensure.

(4) If a military spouse or
domestic partner applies for a license to practice podiatric medicine, the Board
will obtain the results of a query of the National Practitioner Data Bank on behalf
of the applicant.

(5) In addition to the documents
required in section (3) of this rule and in OAR 847-080-0013 and 847-080-0017, the
military spouse or domestic partner must submit a copy of the:

(a) Marriage certificate or
domestic partnership registration with the name of the applicant and the name of
the active duty member of the Armed Forces of the United States; and

(b) Assignment to a duty station
located in Oregon by official active duty military order for the spouse or domestic
partner named in the marriage certificate or domestic partnership registration.

Stat. Auth.: ORS 677.265, 677.820 &
HB 2037 (2013)

Stats. Implemented: ORS 677.820,
677.825, 677.830 & HB 2037 (2013)

Hist.: OMB 21-2013(Temp),
f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14

Rule Caption: Legislative
updates to the Health Professionals’ Services Program

Subject: The temporary
rule amendments reflect changes made by 2013 House Bill 2124 regarding the Health
Professionals’ Services Program. Specifically, the rule amendments refer to
the new statutory location for the definition of “substantial noncompliance,”
remove the term “successful completion” from the definitions and add
the substantive information to the rule on Completion Requirements, clarify the
purpose of the investigation into the licensee’s practice that occurs prior
to full enrollment in the program, clearly establish the ability for licensees to
self-refer to the program, exempt enrolled licensees with solely a mental health
disorder from random drug or alcohol testing unless otherwise required by the Board,
require the Board to assess the licensee’s compliance with the monitoring
agreement to complete the program or the contractor to assess compliance if the
licensee is self-referred, specify that civil commitments for mental illness are
considered substantial noncompliance rather than all admissions for mental health
treatment, and allow the Board to review reports from the program for substantial
noncompliance rather than mandating investigation of all reports.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-065-0015

Definitions

The following definitions apply to OAR
chapter 847, division 065, except as otherwise stated in the definition:

(1) “Assessment or evaluation”
means the process an independent third-party evaluator uses to diagnose the licensee
and to recommend treatment options for the licensee.

(4) “Contractor”
means the entity that has contracted with the Division to conduct the HPSP.

(5) “Diagnosis”
means the principal mental health or substance use diagnosis listed in the current
Diagnostic Statistical Manual (DSM). The diagnosis is determined through the assessment
and any examinations, tests or consultations suggested by the assessment.

(7) “DSM” means
the Diagnostic and Statistical Manual of Mental Disorders, published by the American
Psychiatric Association.

(8) “Federal regulations”
means:

(a) As used in ORS 676.185(5)(d),
a “positive toxicology test result as determined by federal regulations pertaining
to drug testing” means a test result that meets or exceeds the cutoff concentrations
shown in 49 CFR ¦40.87 (2009); and

(b) As used in ORS 676.190(5)(g),
requiring a “licensee to submit to random drug or alcohol testing in accordance
with federal regulations” means licensees are selected for random testing
by a scientifically valid method, such as a random number table or a computer-based
random number generator that is matched with licensees’ unique identification
numbers or other comparable identifying numbers. Under the selection process used,
each covered licensee must have an equal chance of being tested each time selections
are made, as described in 40 CFR ¦199.105(c)(5) (2009). Random drug tests must
be unannounced and the dates for administering random tests must be spread reasonably
throughout the calendar year, as described in 40 CFR ¦199.105(c)(7) (2009).

(9) “Fitness to practice
evaluation” means the process a qualified, independent third-party evaluator
uses to determine if the licensee can safely perform the essential functions of
the licensee’s health practice.

(10) “Final enrollment”
means a licensee has provided all documentation required by OAR 847-065-0035 and
has met all eligibility requirements to participate in the HPSP.

(11) “Independent third-party
evaluator” means an individual or center who is approved by the Board to evaluate,
diagnose, and offer treatment options for substance use disorders and/or mental
disorders.

(12) “Licensee”
means a licensed physician, podiatric physician, physician assistant or acupuncturist
who is licensed or certified by the Board.

(13) “Mental disorder”
means a clinically significant syndrome identified in the current DSM that is associated
with disability or with significantly increased risk of disability.

(14) “Monitoring agreement”
means an individualized agreement between a licensee and the contractor that meets
the requirements for a diversion agreement set by ORS 676.190.

(15) “Positive toxicology
test result” means a test result that meets or exceeds the cutoff concentrations
shown in 49 CFR 40.87 (2009), a test result that shows other drugs or alcohol, or
a test result that fails to show the appropriate presence of a currently prescribed
drug that is part of a treatment program related to a condition being monitored
by HPSP.

(17) “Self-referred licensee”
means a licensee who seeks to participate in the program without a referral from
the Board.

(18) “Substance abuse”
means a disorder related to the taking of a drug of abuse (including alcohol); to
the side effects of a medication; and to a toxin exposure, including: substance
use disorders (substance dependence and substance abuse) and substance-induced disorders
(including but not limited to substance intoxication, withdrawal, delirium, and
dementia, as well as substance induced psychotic disorders and mood disorders),
as defined in DSM criteria.

(19) “Substantial non-compliance”
means that a licensee is in violation of the terms of his or her monitoring agreement
in a way that gives rise to concerns about the licensee’s ability or willingness
to participate in the HPSP. Substantial non-compliance and non-compliance include,
but are not limited to, the factors listed in ORS 676.185(5). Conduct that occurred
before a licensee entered into a monitoring agreement does not violate the terms
of that monitoring agreement.

(20) “Toxicology testing”
means urine testing or alternative chemical monitoring including blood, saliva,
breath or hair as conducted by a laboratory certified, accredited or licensed and
approved for toxicology testing.

Eligibility for Participation in Health
Professionals Services Program

(1) Licensee must be evaluated by an independent
third-party evaluator.

(2) The evaluation must include
a diagnosis of a substance use disorder and/or mental disorder with the appropriate
diagnostic code from the DSM, and treatment options.

(3) Licensee must provide a
written statement agreeing to enter the HPSP and agreeing to abide by all rules
established by the Board.

(4) Licensee must enter into
the “HPSP Monitoring Agreement.”

(5) The Board will determine
whether a Board-referred licensee’s practice has presented or presents a danger
to the public. The contractor will determine whether a self-referred licensee’s
practice has presented or presents a danger to the public.

(1) Provisional Enrollment:
To be provisionally enrolled in the program, a self-referred licensee must:

(a) Sign a written consent allowing
disclosure and exchange of information among the contractor, the licensee’s
employer, independent third-party evaluators and treatment providers;

(b) Sign a written consent allowing
disclosure and exchange of information among the contractor, the Board, the licensee’s
employer, independent third-party evaluators and treatment providers in the event
the contractor determines the licensee to be in substantial non-compliance with
his or her monitoring agreement as defined in OAR 847-065-0065;

(c) Attest that the licensee
is not, to the best of the licensee’s knowledge, under investigation by the
Board; and

(d) Agree to and sign a monitoring
agreement.

(2) Final Enrollment: To move
from provisional enrollment to final enrollment in the program, a self-referred
licensee must:

(a) Obtain at the licensee’s
own expense and provide to the contractor, an independent third-party evaluator’s
written evaluation containing a DSM diagnosis and diagnostic code and treatment
recommendations;

(b) Agree to cooperate with
the contractor’s investigation to determine whether the licensee’s practice
while impaired presents or has presented a danger to the public; and

(c) Enter into an amended monitoring
agreement, if required by the contractor.

(3) Once a self-referred licensee
seeks enrollment in the HPSP, failure to complete final enrollment may constitute
substantial non-compliance and may be reported to the Board.

(1) Agree to report any arrest
for or conviction of a misdemeanor or felony crime to the contractor within three
business days after the licensee is arrested or convicted of the crime;

(2) Comply continuously with
his or her monitoring agreement, including any restrictions on his or her practice,
for at least two years or longer, as specified in the monitoring agreement;

(3) Abstain from mind-altering
or intoxicating substances or potentially addictive drugs, unless the drug is approved
by the contractor and prescribed for a documented medical condition by a person
authorized by law to prescribe the drug to the licensee;

(4) Report use of mind-altering
or intoxicating substances or potentially addictive drugs within 24 hours to contractor;

(5) Participate in a treatment
plan approved by a third-party evaluator or treatment provider;

(6) Limit practice as required
by the contractor or the Board;

(7) Cooperate with supervised
monitoring of practice;

(8) Participate in a follow-up
evaluation, when necessary, of licensee’s fitness to practice;

(9) Submit to random drug or
alcohol testing, unless the licensee is diagnosed with solely a mental health disorder
and the Board does not otherwise require the licensee to submit to random drug and
alcohol testing;

(10) Report at least weekly
to the contractor regarding the licensee’s compliance with the monitoring
agreement;

(11) Report applications for
licensure in other states, changes in employment and changes in practice setting
to the contractor;

(12) Agree to be responsible
for the cost of evaluations, toxicology testing, treatment and monitoring;

(13) Report to the contractor
any investigations or disciplinary action by any state, or state or federal agency,
including Oregon;

(14) Participate in required
meetings according to the treatment plan; and

(1) The time spent participating in a monitored
program before transferring from the Health Professionals Program to the Health
Professionals’ Services Program effective July 1, 2010, will be counted toward
the required term of monitored practice.

(2) The licensee will remain
enrolled in the program for a minimum of two consecutive years.

(3) The Board-referred licensee
must have complied with the licensee’s monitoring agreement to the satisfaction
of the Board. The self-referred licensee must have complied with the licensee’s
monitoring agreement to the satisfaction of the contractor.

(1) The contractor will report substantial
non-compliance with a diversion agreement to the Board within one business day after
the contractor learns of the substantial non-compliance, including but not limited
to information that a licensee:

(a) Engaged in criminal behavior;

(b) Engaged in conduct that
caused injury, death or harm to the public, including engaging in sexual impropriety
with a patient;

(c) Was impaired in a health
care setting in the course of the licensee’s employment;

(d) Received a positive toxicology
test result;

(e) Violated a restriction on
the license’s practice imposed by the contractor or the Board;

(f) Was civilly committed for
mental illness;

(g) Entered into a diversion
agreement, but failed to participate in the HPSP;

(h) Was referred to the HPSP,
but failed to enroll in the HPSP;

(i) Forged, tampered with, or
modified a prescription;

(j) Violated any rules of prescriptive
authority;

(k) Violated any provisions
of OAR 847-065-0055;

(l) Violated any terms of the
diversion agreement; or

(m) Failed to complete the monitored
practice requirements as stated in OAR 847-065-0060.

(2) The Board will review reports
from the program. The Board may request the contractor to provide the licensee’s
complete record, and the contractor must send these records to the Board as long
as a valid release of information is in place.

(3) If the Board finds that
a licensee is substantially noncompliant with a diversion agreement, the Board may
investigate and determine the appropriate sanction.

Notes1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2012.